Provider Demographics
NPI:1043275944
Name:MORRIS, DARREN TRAVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:TRAVIS
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 DUCK SLOUGH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5072
Mailing Address - Country:US
Mailing Address - Phone:727-375-5885
Mailing Address - Fax:
Practice Address - Street 1:2208 DUCK SLOUGH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5072
Practice Address - Country:US
Practice Address - Phone:727-375-5885
Practice Address - Fax:727-375-5841
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280809900Medicaid
FLP00672403OtherRR MEDICARE
FL280809900Medicaid
FLP00672403OtherRR MEDICARE